Same-sex marriage ruling will reshape health insurance domain

The U.S. Supreme Court's 5-4 decision granting all same-sex couples the right to marry will change the health insurance landscape.

More employees will likely add their same-sex partners to their health plans. But a number of employers may drop domestic partnership benefits and instead require same-sex couples to marry.

Under the Affordable Care Act, all insurance companies must offer the same individual or group health plans to legally married gay and lesbian couples as those offered to married heterosexual couples.

The ruling last week answered only constitutional questions, so some logistical questions still need to be answered. But “from an HR, compliance and legal risk perspective, clearly there will be the general belief that benefits will follow that recognition” of same-sex spouses, said Tony Holmes, a health benefits partner at consulting firm Mercer in New York.

However, if an employer has only offered domestic partnership benefits to same-sex couples because they didn't have the right to marry until now, “then those programs likely are not valid anymore,” said Jen Cornell, a labor and employment attorney at Nilan Johnson Lewis in Minneapolis.

Delta Air Lines and Verizon Communications, for example, have already begun eliminating those options. Excellus Blue Cross and Blue Shield in New York gave its employees about 15-months' notice that to qualify for employer-paid health insurance, partners would have to marry.

Domestic partnership benefit programs limited to same-sex couples may no longer stand up in court, Cornell said, particularly in states that prohibit discrimination based on sexual orientation. If an employer limited the program to same-sex couples, an opposite-sex couple could sue for the same benefit and win.

Some employers might not feel comfortable telling their workers they must get married to keep their health coverage. The Human Rights Campaign urged employers Friday to continue offering domestic partner benefits “as a sign of sustained commitment to family diversity.”

Some employers offer domestic partnership benefits to all parties as a way to attract talent. Such a benefit may appeal to young heterosexuals who want to delay or avoid marriage but still have committed relationships.

At the very least, many large employers view the court's decision as an administrative weight that is being lifted. “The nation's top employers ... will be relieved to be able to treat their employees uniformly, regardless of where they live or work,” Annette Guarisco Fildes, CEO of the ERISA Industry Committee, a trade group that represents large self-insured companies, said in a written statement.

Broader health insurance coverage also may help same-sex spouses with lingering health problems. Lesbian, gay, bisexual and transgender people often suffer from higher rates of chronic health conditions, according to an April report from the Kaiser Family Foundation.